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Going Sleeveless

By Richard Smith
Posted On Jan 11, 2011

In the war against droop and jiggle, you’ve got the right to bare arms.


It’s a common problem suffered the world over. We age or lose an excessive amount of weight and—voilà—our arms are flapping in the wind. Not a pretty picture by any stretch of the imagination. And when we reach the point of hiding those arms to avoid looks of horrified wonder at the sagging flesh jiggling from under those upper arms, one could argue that it’s no longer strictly “cosmetic.”

As one Californian woman explains, her family never missed an opportunity to make fun of the flapping skin under her upper arms. “In particular they liked touching it as I reached for things,” says Cindy K., who asked that we use a fictitious name to conceal her identity.

Up In Arms

Unfortunately, exercise alone can’t sculpt away the problem. Commonly referred to as “bat wings,” getting rid of those dreaded flabby arms is limited to liposuction for mild cases or an arm lift (brachioplasty) to remove both fat and skin in more severe cases.

For Cindy, “bat wings” were the unwelcome byproduct of weight loss. “I had gotten into fitness and went from a size 14 to a size 4. But my arms stayed looking flabby despite working out.” Her cosmetic surgeon, Ronald E. Moser, M.D., of the AesthetiCare Cosmetic Surgery Institute in San Juan Capistrano, CA, told the despairing 38-year-old woman that exercise would never slim those problem arms. “It builds muscle mass, which makes them appear bigger, while the hanging skin becomes just that much more unsightly,” he explained to her during an initial consultation.


With the advice of her doctor, Cindy elected to undergo liposuction. For this out-patient procedure, “We start by making a quarterinch-long incision in the loose skin around the elbow,” says Dr. Moser. “Through that opening we then insert a thin suction tube long enough to reach as far as the shoulder. The bulk of the fat is removed through this [tube]. One that’s thinner still is used afterward to fine-tune our work.”

Some cosmetic surgeons prefer to perform this procedure with the aid of a VASER system, such as Boca Raton, FL-based Janee D. Steinberg, M.D., founder and medical director of Advanced Cosmetic Laser Center. “VASER is a special type of liposuction technology that uses ultrasound to liquefy the fat before it’s suctioned out,” explains Dr. Steinberg. “We feel this approach allows for better sculpting of the area.”

Whether traditional or high-tech, patients tend to experience minimal post-procedural pain and downtime. But beautiful arms don’t come cheap: The procedure will cost you anywhere from $1,000 to $3,000.


Cut & Chisel

For others who may need to actually remove skin to get desired results, an arm lift—or brachioplasty—may be performed to remove excess upper-arm skin.

“After we prep the patient, we cut away and discard the skin through all the layers of fat, down to the muscle—a strip measuring about 12 inches in length by one to three inches in width,” Dr. Moser explains. “We also loosen the fat where it attaches to the muscle around the back of the arm. This allows us to pull the skin and fat forward together by rolling them toward the inner part of the arm. Finally, we stitch up the various layers of fat and skin.”

Dr. Steinberg notes that recovery after an arm lift requires that you wear movement-restricting girdle-slings on each arm for the better part of a month. Being hemmed in like that can prove exasperating for highly active patients, but it’s necessary to prevent the incision area from coming open during healing, she says.

Once healing is complete, a scar running from the armpit to the elbow will probably remain, though it won’t be obvious since it faces the trunk of the body. “Cortisone injections once a month over a period of time can flatten and improve the appearance of such scars,” Dr. Steinberg assures. “Also very effective is treatment with a Fraxel laser. Additionally, twice-daily use of a siliconized scar reduction cream such as Dermatix can, after several months, make a dramatic difference in scar thickness.”


Taking up to five hours to complete, this surgical procedure is much more involved. Prices range from $4,000 to $8,000, and the work is typically performed at outpatient facilities.

Worth The Wait

Whether a recipient of liposuction or an arm lift, patients find it takes about half a year before getting peak results. But, according to Cindy, the wait’s worth it. Currently at that six-month mark, she can’t stop raving about how terrific her arms look. “I’m wearing short-sleeve and sleeveless clothes I would before never have even dared dream of buying,” she says. “Best of all, my family can’t tease me anymore.”